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on January 6, 2005

Stroke. 2005
Published online before print January 6, 2005, doi: 10.1161/01.STR.0000152945.28543.4a
A more recent version of this article appeared on February 1, 2005
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Submitted on September 23, 2004
Revised on October 29, 2004
Accepted on November 3, 2004

Trends in Fatal and Nonfatal Strokes Among Persons Aged 35 to ≥85 Years During 1991-2002 in Finland

Pia Pajunen MD, PhD; Rauni Pääkkönen MSc(Tech); Helena Hämäläinen MD, PhD; Ilmo Keskimäki MD, PhD; Tiina Laatikainen MD, PhD; Marja Niemi MD, PhD; Hannu Rintanen MD, PhD; and Veikko Salomaa MD, PhD*

From the KTL/National Public Health Institute, Helsinki (P.P., R.P., T.L., V.S.); Social Insurance Institution, Turku (H.H.); and National Research and Development Centre for Welfare and Health, Helsinki (I.K., M.N., H.R.), Finland.

* To whom correspondence should be addressed. E-mail: veikko.salomaa{at}ktl.fi.

Background and Purpose--Declining trends in the incidence and mortality of stroke have been observed in Finland since the beginning of the 1980s until 1997. In this study we analyzed the trends in fatal and nonfatal strokes in Finland during 1991-2002.

Methods--The Finnish Hospital Discharge Register was linked to the National Causes of Death Register to produce a Cardiovascular Disease Register, which includes data on 410 760 cerebrovascular events (International Statistical Classification of Diseases, 10th Revision [ICD-10] codes I60-I69) in patients aged ≥35 years in 1991-2002.

Results--Age-standardized incidence of first-ever stroke (ICD-10 codes I60-I64, excluding I63.6) per 100 000 persons declined during 1991-2002 annually by 2.2% (95% CI, -2.4% to -1.9%) among men and 2.5% (-2.8% to -2.2%) among women aged 35 to 74 years. In patients aged 75 to 84 years, the change in the incidence of first-ever stroke was -2.6% per year (-3.0% to -2.2%) among men and -3.2% per year (-3.5% to -2.9%) among women. A similar trend was observed also in the oldest age group, in patients aged ≥85 years. Among patients aged 35 to 74 years, the 28-day case fatality of first-ever stroke declined annually by 3.2% (-3.9% to -2.5%) among men and by 3.0% (-3.8% to -2.2%) among women. A significant decrease was found in the 28-day case fatalities of all subtypes of stroke in this age group.

Conclusions--The favorable development in stroke incidence, mortality, and case-fatality has continued in Finland during 1991-2002.


Key words: epidemiology • Finland • incidence • mortality • stroke




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